Does Accutane cause weight gain or weight loss?

Table of Content:
Can I get an Accutane prescription via Miiskin? | Can Accutane cause weight gain? | What the research says | Can Accutane cause weight loss? | What to watch for and when to talk to your doctor | Tracking your symptoms

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If you’ve battled severe acne or papulopustular rosacea and are now considering Accutane (isotretinoin) as a treatment option, it’s completely natural to wonder whether this powerful medication—well-known for its intense side effects—might also impact your weight. The good news? You can breathe a little easier. Weight gain or weight loss is not listed as a known side effect of isotretinoin by any of the major drug manufacturers, however for some patients it may indirectly cause weight gain or weight loss, keep reading to learn why this happens.

Dr. Eric Howell, board-certified dermatologist, says that while every individual responds to medications differently, there is currently no clinical evidence linking Accutane (isotretinoin) to significant weight changes. 

He says that in fact, most dermatologists do not consider weight fluctuation a typical concern during Accutane treatment. However, it’s still important to monitor your body and talk to your doctor if you notice any unexpected changes during your treatment.

Can I get an Accutane prescription via Miiskin?

Yes, absolutely. Getting Accutane via Miiskin is safe, affordable and convenient. Accutane treatment requires monthly visits to the dermatology clinic which can make it quite costly, but with Miiskin you can obtain care from a board-certified dermatologist for only $59 per month.

Can Accutane cause indirect weight gain in some people? 

Dr. Howell says that while Accutane (isotretinoin) is not directly linked to weight gain, some users report gaining weight during their treatment. These changes are more likely due to indirect effects of the medication—physical and emotional side effects that may influence daily habits, activity levels, or metabolism. Here’s a closer look at the possible reasons behind those weight fluctuations.

Why can Accutane cause weight gain indirectly?

Increased fat intake to enhance absorption

Accutane is a fat-soluble medication, meaning it is best absorbed when taken with dietary fat. Dr. Howell says that he often advises his patients to take their medication with a high-fat meal to improve effectiveness. In response, some users may deliberately increase their daily fat intake—sometimes significantly—to meet this requirement. While beneficial for drug absorption, this increase in dietary fat can also lead to a higher overall calorie intake, which may contribute to weight gain over time if not balanced with activity or nutritional awareness.

Fatigue and low energy

Many Accutane users report feeling more tired or sluggish than usual. In fact, fatigue has been documented in up to 3% of people taking isotretinoin, according to clinical data¹. If you’re feeling consistently low on energy, you may find yourself eating more, exercising less or being more sedentary overall. Over time, this reduction in physical activity can contribute to gradual weight gain.

Muscle and joint pain

Muscle aches and joint discomfort are among the more common side effects of Accutane, affecting as many as 20% of users^{2 3}. While usually mild and temporary, this discomfort can interfere with your motivation to work out or stay physically active. Less movement means fewer calories burned, which—combined with a stable or increased food intake—could lead to weight gain over the course of treatment.

Mood changes and emotional eating

Although very rare, Accutane has been associated with changes in a person’s mood. When this occurs, it can also disrupt sleep, alter appetite, and lead to emotional eating or loss of motivation to stay active—all of which may contribute to weight gain. If you notice changes in your mental health during treatment, it’s important to consult your online dermatologist.

Possible metabolic shifts

Accutane has been shown to affect cholesterol levels and blood sugar in some users, suggesting a potential influence on metabolism. Although the link between isotretinoin and metabolic rate isn’t fully understood, some researchers speculate that the medication might alter how the body processes glucose and stores fat^{4 5 6}. These subtle shifts in metabolic function could, in theory, contribute to weight changes in certain individuals.

What research says about Accutane and weight gain

Current scientific evidence indicates that isotretinoin, commonly known by the brand name Accutane, does not directly cause significant weight gain or loss.​

Clinical studies on weight and BMI while on Accutane treatment

A 2016 study investigated the effects of isotretinoin on body mass index (BMI) and certain hormones related to weight regulation. The study found no significant changes in BMI after three months of treatment. However, it did observe increases in serum adiponectin and leptin levels—hormones involved in appetite and metabolism—suggesting potential anti-inflammatory effects of the medication⁷. 

Similarly, a 2024 study assessed weight and metabolic parameters in patients undergoing isotretinoin therapy. The researchers reported no statistically significant changes in weight, BMI, or markers of metabolic syndrome after treatment, reinforcing the notion that isotretinoin does not have a substantial impact on weight⁸.

Hormonal and metabolic considerations while on Accutane treatment

While some studies have noted changes in hormones like leptin and adiponectin during Accutane (isotretinoin) therapy, these alterations have not been conclusively linked to weight changes. For instance, a study found that isotretinoin treatment led to increased levels of leptin and adiponectin but did not result in significant weight fluctuations⁹.​

Patient experiences related to weight due to Accutane treatment 

Dr. Howell says that despite the lack of strong clinical evidence, some patients report experiencing weight changes during isotretinoin treatment. These anecdotal accounts vary, with some individuals note weight gain and others report weight loss. Dr. Howell says that such variations may be influenced by individual factors like changes in appetite, lifestyle, or concurrent health conditions.​

Can Accutane cause indirect weight loss in some people? 

Dr. Howell says that similarly to how Accutane (isotretinoin) can cause weight gain, it can also cause indirect weight loss in some people, though it’s not a common side-effect.

Why can Accutane cause weight loss indirectly?

Lifestyle changes (no alcohol = fewer calories)

Patients on Accutane are strongly advised to avoid alcohol because the medication can increase liver strain. As a result, those who used to drink regularly might cut out alcohol completely during their course. This can have a significant caloric impact, especially if alcohol was consumed frequently or in large amounts. For instance, cutting out beer or cocktails (which can contain 150–300+ calories per serving) multiple times per week can naturally reduce overall calorie consumption.

Less junk food due to no hangovers

Without alcohol, hangovers are no longer an issue, which means many people stop engaging in “hangover eating” — like ordering fast food or snacking heavily the day after drinking. This change in behavior can lead to healthier food choices overall, more stable meal routines, and a net decrease in high-calorie, low-nutrient foods that might have been consumed regularly before.

Gastrointestinal side effects (appetite suppression, nausea, digestive changes)

Many people experience side effects like nausea, stomach discomfort, or a reduced appetite while on Accutane. These symptoms, although usually mild, can lead to eating less throughout the day or skipping meals altogether. Some users also report food aversions during treatment, particularly to greasy or rich foods. Over weeks or months, these small reductions in calorie intake can add up and result in slight weight loss.

Mood or energy changes affecting appetite

Accutane can influence mood and energy levels which in some people may encourage them to eat more, but for some people it can affect motivation to cook, eat, or snack regularly. This behavior can lead to unintentional calorie deficits, especially if the person eats less than usual. 

Dry mouth or changes in taste

Some people on Accutane report dry mouth or altered taste perception, which can make food less enjoyable. If water doesn’t satisfy thirst or food tastes “off,” this might lead to less snacking, fewer cravings, or skipping meals altogether — again contributing to subtle, unintentional weight loss.

What to watch for and when to talk to your dermatologist

Dr. Howell says that while mild weight changes on Accutane can happen — due to appetite shifts, lifestyle changes, or side effects — it’s important to know what’s normal and when to seek medical advice.

What kind of weight changes are normal?

• Slight weight gain or weight loss (a few pounds) during treatment can be expected
• These changes are often temporary and tied to side effects like nausea, reduced appetite, or lifestyle adjustments such as cutting out alcohol
• As long as your energy levels, mood, and general health remain stable, these mild changes are usually not a cause for concern

When it might be a sign of something else?

• Significant or sudden weight loss or gain (10+ pounds in a short time)
• Loss of appetite, binge eating, or unusual cravings could indicate emotional side effects such as depression
• Weight changes accompanied by severe fatigue, mood swings, or severe gastrointestinal distress could point to other underlying issues and should not be ignored

The importance of tracking your symptoms

Dr. Howell recommends monitoring how Accutane affects you by keeping a symptom journal or using a tracking app to log physical and emotional changes throughout treatment — including weight, mood, appetite, and energy levels. Tracking these details consistently can help you identify patterns early and give your dermatologist valuable insight during follow-up appointments. If anything feels off or if weight changes begin to affect your well-being, it’s important to reach out to a healthcare provider promptly, as early intervention can make a significant difference.

Article References:
https://pubmed.ncbi.nlm.nih.gov/21198520/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9377170/
https://www.pagepress.org/journals/dr/article/view/9845/9544
https://www.mdpi.com/2039-7283/14/3/81
https://pmc.ncbi.nlm.nih.gov/articles/PMC7350794/
https://pmc.ncbi.nlm.nih.gov/articles/PMC6898905/
https://pmc.ncbi.nlm.nih.gov/articles/PMC5004210/
https://www.dermatologytimes.com/view/weight-change-with-isotretinoin-treatment-for-acne-vulgaris-not-statistically-significant

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